The goal of this project is to identify and evaluate mechanisms for cancer educational efforts in hard to reach rural and urban populations. A panel of residents over 40 years of age and in the lowest third of the population in Illinois with respect to income were screened regarding their knowledge, attitude and practice relative to cancer prevention and early detection. In Wave 1 of the panel phase eligible respondents were asked to participate by permitting us to verify their behavior with the health care providers from whom they obtained their regular health care. All individuals in the study were then divided into two strata. One stratum received a specially designed communication; the other received pamphlets only. Six months after the mailing of the experimental communication respondents were reinterviewed and changes in knowledge, attitude and behavior from that reported in the baseline were noted. All behavior was verified with the health care providers following both Wave 1 (when the consent forms were obtained) and Wave 2, conducted six months following the experimental mailing.